The present invention relates generally to medical endoscopes, and more particularly to a catheter for cleaning the fiberoptic window end of a bronchoscope or any endoscope.
A bronchoscope is a flexible, steerable, fiberoptic equipped probe that is advanced into the lower respiratory tract for seeing inside ("visualizing") the respiratory tract. It is typically used for finding and collecting biopsy samples to determine the extent and etiology of respiratory disease, particularly cancer.
A typical bronchoscope has a single hollow channel or conduit (called a lumen, a biopsy channel or a working channel) throughout its length for passage of biopsy and other instruments; two fiberoptic channels for providing illumination; and, a single fiberoptic channel for visualization.
Other endoscopes may have different numbers of lumina and filled channels according to the needs of the particular medical procedures for which they are used.
Guiding a bronchoscope, or other endoscope, to a desired destination is a meticulous task, requiring frequent partial back ups and restarts and deft manipulation of the bronchoscope as it is fed into a body opening.
Unfortunately, the fiberoptic-window, located at the far, or lens end of the fiberoptic visualization channel, the end opposite from the eyepiece, frequently becomes coated with various bodily substances. This prevents visualization, thus disabling the bronchoscope and interrupting the procedure.
Past methods for cleaning debris from the fiberoptic window include the lavage method, in which the lens end of the bronchoscope is maneuvered so that it faces a body structure. A liquid is then rapidly injected through the biopsy channel or lumen to splash against the structure and try to reflect the splashed liquid back against the fiberoptic window surface to clean it.
Unfortunately, the lavage method is only occasionally successful, especially when blood clots soil the end of the bronchoscope. This technique is nearly impossible to use when the view through the bronchoscope is completely obstructed.
When a bronchoscope cannot be cleaned by the lavage or other prior art in vivo methods, the bronchoscope must be withdrawn to clean and its hard-earned positioning is then lost. Repositioning and revisualization of concerned structures is time consuming and intricate. It is painstakingly difficult to rediscover small and elusive lesions and tumors. Moreover, every time the bronchoscope is reinserted, dangerous reexposure to pathological microorganisms occurs, increasing the risk of infection and sepsic incidence. Consecutive reinsertions, or intubations, of the endoscope are progressively difficult and can also precipitate laryngospasm, a life threatening complication.
The endoscopic prior art includes a variety of apparatus and methods for cleaning soiled fiberoptic window surfaces. Typically, such apparatus is part of a separate outer sheath or other conduit that surrounds the endoscope either only at its lens end, or along its length. Such separate sheaths typically include a tube to deliver liquid to the sheath and ending in either a nozzle pointed back toward the fiberoptic window, or simply radially inwardly directed openings so that the fluid can clean the fiberoptic window when the endoscope is pulled back slightly within the sheath.
These prior art apparatus suffer from a number of deficiencies, not the least of which is that the sheaths or other endoscope surrounding apparatus add undesirable additional complexity and size to endoscopic probes.
Another problem with such sheaths is that they are typically too complex, and thus costly, to be made disposable. They are also difficult to clean and difficult to sterilize.
Thus it is seen that there is a need for an apparatus and method for cleaning endoscope fiberoptic windows in vivo without having to remove or reposition the endoscope.
It is, therefore, a principal object of the present invention to provide a simple and straightforward apparatus and method for cleaning endoscope fiberoptic windows in vivo without having to remove or reposition the endoscope.
It is a feature of the present invention that it will work, without requiring modification of either the invention or the endoscope, with any endoscope having an open channel.
It is another feature of the present invention that it can be easily made in a variety of different sizes using conventional catheter components to work with any size endoscope.
It is a further feature of the present invention that it can be made inexpensively and made disposable.
It is an advantage of the present invention that its use is fast, straightforward, easy and convenient.
It is another advantage of the present invention that it can be operated by feel and will work even when the view through the visualization channel is completely obstructed.
These and other objects, features and advantages of the present invention will become apparent as the description of certain representative embodiments proceeds.